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NPI Code Detail

MEDICARE: JESSICA DUEMMEL NURSE PRACTITIONER

MEDICARE:   JESSICA  DUEMMEL  NURSE PRACTITIONER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse308373AZ
2363LF0000XFamily Nurse Practitioner308373AZ
3363LA2200XAdult Health Nurse Practitioner308373AZ
4363L00000XNurse Practitioner308373AZ

General Provider Information

NPI Number : 1114761236
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA DUEMMEL NURSE PRACTITIONER
Provider Business Mailing Address
First Line : PO BOX 33269
Second Line :
City : PHOENIX
State : AZ
Zip : 85067-3269
Country : US
Telephone Number : 602-406-4786
Fax Number : 916-636-4358
Provider Business Practice Location Address
First Line : 500 W THOMAS RD STE 850
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-4218
Country : US
Telephone Number : 602-406-1150
Fax Number : 602-406-1159
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2024
Last Update Date : 03/16/2026

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Directions to “ JESSICA DUEMMEL NURSE PRACTITIONER” Practice Location

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